Technology in Parkinson's disease: Challenges and opportunities.
Technology in Parkinson's disease: Challenges and opportunities.
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DOI：
10.1002/mds.26642
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发表时间：
2016-09
影响因子：
8.6
通讯作者：
Papapetropoulos, Spyros
中科院分区：
文献类型：
--
作者：
Espay, Alberto J;Bonato, Paolo;Nahab, Fatta B;Maetzler, Walter;Dean, John M;Klucken, Jochen;Eskofier, Bjoern M;Merola, Aristide;Horak, Fay;Lang, Anthony E;Reilmann, Ralf;Giuffrida, Joe;Nieuwboer, Alice;Horne, Malcolm;Little, Max A;Litvan, Irene;Simuni, Tanya;Dorsey, E Ray;Burack, Michelle A;Kubota, Ken;Kamondi, Anita;Godinho, Catarina;Daneault, Jean-Francois;Mitsi, Georgia;Krinke, Lothar;Hausdorff, Jeffery M;Bloem, Bastiaan R;Papapetropoulos, Spyros
技术的小型化、复杂化、扩散化和可获得性使人们能够捕捉到更多以前无法接触到的帕金森病(PD)现象。然而，更多的信息并没有转化为对疾病复杂性的更好理解，以满足诊断和治疗需求。挑战包括不兼容的技术平台，需要大规模和长期地部署传感器技术(特别是在脆弱的老年患者中)，以及通过敏感的测量技术获得的“大数据”与其有限的临床应用之间的差距。如果开发新技术作为开放源码和/或开放硬件平台的一部分，从而实现多渠道数据采集，对以帕金森病为特征的广泛的电机和非电机问题敏感，并适应于自我调整的个性化治疗提供系统，则可以实现重大机会。国际帕金森和运动障碍学会技术特别工作组受托召集工程师、临床医生、研究人员和患者，以促进具有高患者依从性的综合测量和闭环治疗系统的开发，这些系统还有助于：1)鼓励采用临床病理生理学表型和危重疾病里程碑的早期检测；2)加强症状治疗的定制；3)改善针对未来疾病修改治疗测试的患者亚群；以及4)确定客观生物标记物，以改进临床护理和研究中对损害的纵向跟踪。本文总结了工作组为确定具有改善帕金森病患者临床管理和生活质量潜力的技术开发中的挑战和机会而开展的工作。
The miniaturization, sophistication, proliferation, and accessibility of technologies are enabling the capturing of more and previously inaccessible phenomena in Parkinson disease (PD). However, more information has not translated into greater understanding of disease complexity to satisfy diagnostic and therapeutic needs. Challenges include non-compatible technology platforms, the need for wide-scale and long-term deployment of sensor technology (in particular among vulnerable elderly patients), and the gap between the “big data” acquired with sensitive measurement technologies and their limited clinical application. Major opportunities could be realized if new technologies are developed as part of open-source and/or open-hardware platforms enabling multi-channel data capture, sensitive to the broad range of motor and non-motor problems that characterize PD, and adaptable into self-adjusting, individualized treatment delivery systems. The International Parkinson and Movement Disorders Society Task Force on Technology is entrusted to convene engineers, clinicians, researchers, and patients to promote the development of integrated measurement and closed-loop therapeutic systems with high patient adherence that also serve to: 1) encourage the adoption of clinico-pathophysiologic phenotyping and early detection of critical disease milestones; 2) enhance tailoring of symptomatic therapy; 3) improve subgroup targeting of patients for future testing of disease modifying treatments; and 4) identify objective biomarkers to improve longitudinal tracking of impairments in clinical care and research. This article summarizes the work carried out by the Task Force toward identifying challenges and opportunities in the development of technologies with potential for improving the clinical management and quality of life of individuals with PD.